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    Can nailfold capillaroscopy findings be a marker for uveitis in Behçet’s syndrome?
    (Clinical and Experimental Rheumatology S.A.S., 2025) Zontul, Sezgin; İnanç, Elif; Can, Ahmet; Tay, Şeyma Tokay; Çolak, Hüseyin; Cumurcu, Tongabay; Yolbas, Servet
    Objective To evaluate the differences between BS patients with uveitis and BS patients without uveitis and healthy controls in terms of nailfold capillaroscopic examination. Methods The study was performed on patients with a definite diagnosis of BS according to the International Criteria for Behçet’s Disease, and healthy controls without BS. The participants were divided into three groups: BS patients with uveitis, BS patients without uveitis and healthy controls. All volunteers were examined by nailfold capillaroscopy for microvascular changes. Results A sample size of 90 participants, including 32 patients with BS with uveitis, 29 patients with BS without uveitis and 29 healthy controls, were included in our study. Fourteen (15.6%) BS patients with uveitis, 14 (15.6%) BS patients without uveitis and 16 (17.8%) healthy controls were female. In our study, we found microhaemorrhage occurrence to be significantly higher in BS patients with uveitis compared to the healthy control group (p=0.028). Although there was no significant difference compared to the BS without uveitis group, microhaemorrhage was approximately 2.5 times more common in the BS with uveitis group. The crossing medians were determined as 2.0 (0.8-3.3) in the BS with uveitis group, 1.3 (0.6-2.7) in the BS without uveitis group and 1.2 (0-3.2) in the healthy control group, showing a statistically significant difference across groups (p<0.001). In the post hoc crossing analysis, a significant difference was detected in the BS with uveitis group compared to the other two groups. A giant capillary was detected in one of the patients with uveitis, but no giant capillary was detected in the volunteers in the other groups. Conclusion Our findings show that microhemorrhage and crossing are associated with uveitis in BS patients. © Copyright CLINICAL AND EXPERIMENTAL RHEUMATOLOGY 2025.
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    GASTROINTESTINAL INVOLVEMENT IN SJÖGREN’S DISEASE
    (2025) Atayan, Yahya; Yolbas, Servet; İnanç, Elif; Albayram, Fuat
    Sjögren’s disease (SjD) is a chronic autoimmune disorder characterized by lymphocytic infiltration of the exocrine glands, which can also affect the gastrointestinal (GI) tract, hepatobiliary system, and pancreatic exocrine tissues. Approximately one-third of patients experience GI-related symptoms, with xerostomia, dysphagia, dyspepsia, and atrophic gastritis being the most commonly reported manifestations. SjD is also associated with autoimmune liver diseases, including autoimmune hepatitis and primary biliary cholangitis. Pancreatic involvement is less frequent, but may present as autoimmune pancreatitis or exocrine pancreatic insufficiency. The complexity of SjD and the variety of its manifestations underscore the importance of a multidisciplinary management approach, where collaboration among healthcare professionals is crucial for optimising patient outcomes.
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    INCREASED PREVALENCE OF SCOLIOSIS IN PSORIATIC ARTHRITIS: A CROSS-SECTIONAL CASE-CONTROL STUDY
    (2025) Gözükara Bag, Harika Gözde; Ergen, Emre; Yolbas, Servet; Aydogdu, Mesude Seda; Kaya, Zeynep; Zontul, Sezgin; İnanç, Elif
    Aim: Psoriatic arthritis (PsA) is expected to cause an increased risk of scoliosis because it affects the axial skeleton asymmetrically. In this study, we compared the frequency of scoliosis in PsA patients with that in healthy controls (HC) and axial spondyloarthritis (axSpA) patients. Thus, we aimed to explore whether scoliosis might be a clinical feature of PsA and to assess its potential role in differentiating PsA from axSpA. Material and Methods: The study included 60 PsA patients, 60 axSpA patients and 40 HC. All individu-als in the study were assessed for the presence of scoliosis by physical examination. Scoliosis radiog-raphy was performed in those with a positive scoliosis test on physical examination. The Cobb angle was measured using the appropriate method. A two-tailed significance level of 0.05 was considered in all analyses. Results: Within this research, the frequency of scoliosis in PsA patients was compared with the axSpA and HC groups. The Cobb angle value was notably higher in the PsA group compared to axSpA and HC (p=0.006 and p=0.007, respectively). On physical examination, scoliosis findings and coronal spinal curvature, were observed at elevated rates in the PsA group relative to the other two groups (p>0.05 for all, indicating no statistical significance). Scoliosis was more frequent in the PsA group than in the axSpA group (p=0.046). All scoliosis cases in PsA were in mild or moderate severity. Conclusion: Both the frequency of scoliosis and Cobb angle values were greater in PsA than those in axSpA. This outcome may be associated with the asymmetric involvement of lateral spinal structures typical of PsA. Overall, these results indicate that scoliosis could serve as a supportive marker for PsA and may aid in differentiating PsA from axSpA.
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    Is combining methotrexate and leflunomide a safe option for treating rheumatoid arthritis?
    (2025) Aktürk, Semra; Yolbas, Servet; Güneş, Hatice Kübra; Kürüm, Kübra Orhan; Zontul, Sezgin; İnanç, Elif; Çulcu, Sena Cengiz
    Rheumatoid arthritis (RA) is a chronic immune-mediated disease marked by synovial inflammation and systemic features. Early management typically relies on conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), with methotrexate (Mtx) serving as the primary therapeutic agent. When Mtx is contraindicated, leflunomide (Lef) can be used as a treatment strategy. There are concerns about hepatotoxicity, cytopenia, pneumonia, and increased risk of infection when these therapies are combined. In this study, we aimed to evaluate the side effects and treatment duration of the Mtx/Lef combination in patients with RA. All patients admitted to the Rheumatology clinic between 2016 and 2023 and diagnosed with RA were retrospectively reviewed. Patients who received Mtx/Lef combination therapy during this period were identified. The data for patients who continued Mtx/Lef combination therapy were recorded at the last visit, and those who discontinued the combination therapy were recorded at the visit of discontinuation. Adverse effects associated with Mtx/Lef combination therapy were assessed through retrospective review of clinical follow-up notes, laboratory test results, and drug safety monitoring forms. Adverse events leading to treatment discontinuation were classified as either due to side effects or lack of therapeutic response. This study was conducted with a total of 222 participants, comprising 184 females (82.9%) and 38 males (17.1%). No side effects were observed in 141 (63.5%) patients after Mtx/Lef use. Gastrointestinal system side effects were observed in 16.7% of the participants, followed by elevated liver function tests in 11.3%. It was determined that 55% of the participants were unable to continue treatment due to treatment ineffectiveness or side effects. Our study results offer a good safety profile and long-term drug survival. Survival in long-term treatment may contribute to reducing treatment costs.